Abstract: Objective To study the efficacy of telbivudine in blocking mother-to-child transmission of hepatitis B virus infection in pregnant women with serum HBsAg positive and its influence on infant’s response to hepatitis B vaccination. Methods 100 pregnant women with serum HBsAg positive and their 100 newborns were enrolled in our hospital between July 2013 and July 2015,41 out of the pregnant women took telbivudine at 28 week gestation,and 59 didn’t. All newborns were fully vaccinated with hepatitis B vaccine. They were followed-up for 12 months. Serum HBV markers and HBV DNA loads were measured by electrochemical luminescence and serum IFN-γ and IL-10 levels were detected by ELISA. Logistic multivariate regression analysis was used to analyze the facters affecting the response of infants to hepatitis B vaccination. Results Serum HBV DNA load in women receiving antiviral therapy after dilivery was（2.0±1.3） lg IU/ml,significantly lower than 【（7.1±1.6） lg IU/ml,P<0.05】 in women who didn’t receive antiviral therapy;the incidences of cesarean section,premature delivery,postpartum hemorrhage and neonatal asphyxia in women receiving antiviral treatment were 29.3%,12.2%,4.9% and 9.8%,all not significantly different compared with 30.5%,11.9%,5.1% and 8.5%,respectively,in women who didn’t receive antiviral therapy （P>0.05）;at the end of 12-month followed-up,no infant in 41 mothers receiving antiviral therapy was serum HbsAg positive,while six（10.2%） in 59 mothers without antiviral therapy were serum HbsAg positive（x²=4.436,P=0.035）;the strong response rates in 50 infants with high serum IFN-γ and IL-10 levels were much higher than those with lower serum cytokine levels（P<0.05）;Logistic regression analysis showed that high serum IFN-γ and IL-10 levels were the independent factors affecting infants’response to hepatitis B vaccination. Conclusion The application of telbivudine at late gestational stage might block the HBV mother-to-infant transmission in women with serum HbsAg positive,and the detection of serum IFN-γ and IL-10 levels might predict the response of infants’ response to hepatitis B vaccination.

Key words: HbsAg carriers, Telbivudine, Hepatitis B vaccine, Pregnancy, Mother-to-infant trasmission